NeuroDevNet investigators publish review summarizing current knowledge about early signs of autism

Drs. Lonnie Zwaigenbaum and Susan Bryson and co-author Dr. Nancy Garon have published a review article in Behavioural Brain Research entitled “Early identification of autism spectrum disorders,” documenting robust evidence that behavioural signs of autism spectrum disorder (ASD) can be detected as early as one year of age.

Invited by the editor of the journal to undertake the review, Dr. Bryson said the publication is a response to strong and consistent demand for up-to-date information about early detection, which, in turn, provides the opportunity for earlier intervention.

“We’re talking about things you can see with your own eyes – you don’t need sophisticated tools. That’s the importance of our findings,” observed Dr. Bryson.

Frontline clinicians are the most important audience for the research, added Dr. Bryson. “We need to get this information to GPs (family practitioners) – while progress has been made in detecting ASD earlier, too many toddlers are still being missed. The reasons for that are complex – some GPs may not feel confident picking up early signs of ASD. They need to know what questions to ask, and what they should look for. ”

In her clinical practice the same week the review was published online, Dr. Bryson saw the younger brother, aged 3, of a four-year-old boy diagnosed with autism the same day. “Those two brothers should have been picked up earlier,” exclaimed Dr. Bryson.

An important insight gleaned from the review process was just how much material there is that can enable clinicians to detect signs of ASD in children as young as 12 to 18 months old, she said.

Risk markers evaluated in the paper include atypical social communication, repetitive interests and behaviours, motor delays, and atypical regulation of attention and emotion. Unusual development of language and cognitive skills were consistently seen in many high risk infants.

Taken together, findings in the review shed new light on patterns of symptom onset and progression that can assist clinicians in early detection and diagnosis of ASD. “The most important thing I can tell you, is I wouldn’t close any doors,” said Dr. Bryson. “I feel so optimistic in terms of what’s possible here. Between 12-18 months, kids are already showing things we want to interrupt, to make sure pathological pathways don’t get laid down, and get kids on a better developmental trajectory.”

Dr. Bryson and her co-authors suggest the best way to do this may involve a combination of behavioural and biomarker approaches. Full realization of the promise of improved outcomes reflected in their review will require effective knowledge translation, and greater capacity in the health care system to ensure timely access to specialized assessment.